Please use this identifier to cite or link to this item:
https://ahro.austin.org.au/austinjspui/handle/1/28645
Title: | The Hemodynamics of Small Arterial Return Cannulae for Venoarterial Extracorporeal Membrane Oxygenation. | Austin Authors: | Stephens, Andrew F;Wickramarachchi, Avishka;Burrell, Aidan J C;Bellomo, Rinaldo ;Raman, Jaishankar;Gregory, Shaun D | Affiliation: | Intensive Care.. Cardio-respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.. Australian and New Zealand Intensive Care Research Centre, Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia.. Department of Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia.. Department of Critical Care, The University of Melbourne, Melbourne, Australia.. Intensive Care Unit, Alfred Hospital, Melbourne, Australia.. Cardiothoracic Surgery, University of Melbourne, Melbourne, Australia.. Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.. |
Issue Date: | Jun-2022 | Date: | 2022-02-03 | Publication information: | Artificial organs 2022; 46(6): 1068-1076 | Abstract: | Venoarterial extracorporeal membrane oxygenation (ECMO) provides mechanical support for critically ill patients with cardiogenic shock. Typically, the size of the arterial return cannula is chosen to maximize flow. However, smaller arterial cannulae may reduce cannula-related complications and be easier to insert. This in vitro study quantified the hemodynamic effect of different arterial return cannula sizes in a simulated acute heart failure patient. Baseline support levels were simulated with a 17 Fr arterial cannula in an ECMO circuit attached to a cardiovascular simulator with targeted partial (2.0 L/min ECMO flow, 60-65 mmHg mean aortic pressure - MAP) and targeted full ECMO support (3.5 L/min ECMO flow and 70-75 mmHg MAP). Return cannula size was varied (13-21 Fr), and hemodynamics were recorded while keeping ECMO pump speed constant and adjusting pump speed to restore desired support levels. Minimal differences in hemodynamics were found between cannula sizes in partial support mode. A maximum pump speed change of +600 rpm was required to reach the support target and arterial cannula inlet pressure varied from 79 (21 Fr) to 224 mmHg (13 Fr). The 15 Fr arterial cannula could provide the target full ECMO support at the targeted hemodynamics; however, the 13 Fr cannula could not due to the high resistance associated with the small diameter. A 15 Fr arterial return cannula provided targeted partial and full ECMO support to a simulated acute heart failure patient. Balancing reduced cannula size and ECMO support level may improve patient outcomes by reducing cannula-related adverse events. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/28645 | DOI: | 10.1111/aor.14179 | ORCID: | 0000-0002-2271-750X 0000-0003-2623-7009 0000-0001-8430-9678 0000-0002-5448-1917 0000-0002-1650-8939 |
Journal: | Artificial organs | PubMed URL: | 35049072 | PubMed URL: | https://pubmed.ncbi.nlm.nih.gov/35049072/ | Type: | Journal Article | Subjects: | Arterial Cannula Bleeding ECMO ECPR Ischemia Out of Hospital Cannulation Return Cannula Vascular Injury |
Appears in Collections: | Journal articles |
Show full item record
Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.